Provider Demographics
NPI:1538347240
Name:SPANGLER MEDICAL ENTERPRISES, PA
Entity type:Organization
Organization Name:SPANGLER MEDICAL ENTERPRISES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SPANGLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:281-218-7200
Mailing Address - Street 1:PO BOX 572
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77574-0572
Mailing Address - Country:US
Mailing Address - Phone:281-218-7200
Mailing Address - Fax:281-218-7203
Practice Address - Street 1:17000 EL CAMINO REAL STE 201B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2636
Practice Address - Country:US
Practice Address - Phone:281-218-7200
Practice Address - Fax:281-218-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4728207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty